013421273-2-4-2020-02-CC-BNEN-BLGUN8-20200204144332

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013421273
Report Date: 02/04/2020
Date Signed: 02/04/2020 02:43:44 PM

COMPREHENSIVE INSPECTION

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	MENDEZ, SARA MARINA		FACILITY NUMBER:	013421273
ADMINISTRATOR:	MENDEZ, SARA MARINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 229-3612
CITY:	BERKELEY	STATE: CA	ZIP CODE:	94702
CAPACITY:	14	CENSUS: 11	DATE:	02/04/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Licensee Sara Mendez		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 02/04/2020, Licensing Program Analyst (LPA) Brittany Newton made an unannounced visit for the purpose of conducting a required annual inspection. LPA was met by licensee Sara Mendez and assistant M. Burk. Present for the visit was 11 preschool aged children. The home was toured to conduct a health and safety inspection. The home is a two story home. The home consists of a living room, kitchen, 2 upstairs bedrooms, 1 upstairs bathroom, den, fenced back yard, fenced front yard and garage. The 2 upstairs bedrooms, kitchen and garage are the off-limit areas. Licensee states that there are no firearms. The isolation area is the living room. There are no pools, spas, hot tubs, fish ponds or similar bodies of water. All poisons, detergents, cleaning compounds and medications are stored in areas which are inaccessible to children. There are no fireplaces or open face heaters accessible to children. The home has a 3A40BC fire extinguisher and a combination smoke and carbon monoxide detector. The licensee has been conducting fire drills with the last one being 01/06/2020. There is a gate at the bottom of the staircase which is to prevent the children from going to the second floor. Licensee provides active supervision when taking the children to the upstairs bathroom. Licensee uses the front and back yards for outdoor play. LPA inspected the outdoor area which was found free of hazards. The home has turtles and a betta fish. LPA observed napping equipment stored properly. The licensee provides two snacks and lunch for the children in care. CPR and First Aid certificates are current and expire on 07/15/2020. LPA reviewed children records which were found in compliance. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. Currently, the licensee has no kids in care requiring medicine. The licensee previously submitted a plan, but will be completing another one. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MENDEZ, SARA MARINA	FACILITY NUMBER: 013421273
	VISIT DATE: 02/04/2020

NARRATIVE

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Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter and the requirement to complete the training every two years.

LPA is reminding licensee that a camera monitor while children are sleeping should not be used as sole supervision for health and safety of children.

A child care roster was obtained.

The Licensee was given a copy of A Child Care Provider's Guide to Safe Sleep pamphlet and LPA discussed safe sleep practices and policy. No deficiencies observed at this visit. A Notice of Site visit was given and facility was reminded that it is required to be posted for 30 days. Exit interview conducted, appeal rights provided, and a copy of this report was left with Licensee Sara Mendez.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Brittany Newton	TELEPHONE: (510) 622-2594
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

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